title: Effect of custom-made and prefabricated orthoses on grip strength in persons with carpal tunnel syndrome.
abstract: BACKGROUND
  Based on the literature, patients with carpal tunnel syndrome are suggested to wear a custom-made wrist orthosis immobilizing the wrist in a neutral position. Many prefabricated orthoses are available on the market, but the majority of those do not assure neutral wrist position.
  
  
  OBJECTIVE
  We hypothesized that the use of orthosis affects grip strength in persons with carpal tunnel syndrome in a way that supports preference for custom-made orthoses with neutral wrist position over prefabricated orthoses.
  
  
  METHODS
  Experimental.
  
  
  METHODS
  Comparisons of grip strength for three types of grips (cylindrical, lateral, and pinch) were made across orthosis types (custom-made, prefabricated with wrist in 20° of flexion, and none) on the affected side immediately after fitting, as well as between affected side without orthosis and nonaffected side.
  
  
  RESULTS
  Orthosis type did not significantly affect grip strength (p = 0.661). Cylindrical grip was by far the strongest, followed by lateral and pinch grips (p < 0.050). The grips of the affected side were weaker than those of the nonaffected side (p = 0.002).
  
  
  CONCLUSIONS
  In persons with carpal tunnel syndrome, neither prefabricated orthoses with 20° wrist extension nor custom-made wrist orthoses with neutral wrist position influenced grip strength of the affected hand. Compared to the nonaffected side, the grips of the affected side were weaker.
  
  
  CONCLUSIONS
  The findings from this study can be used to guide application of orthoses to patients with carpal tunnel syndrome.
authors.affiliation: University Rehabilitation Institute, Ljubljana, Slovenia maja.mlakar@ir-rs.si.
authors.forename: Maja
authors.initials: M
authors.lastname: Mlakar
authors.affiliation: Jönköping University, School of Health Sciences, Jönköping, Sweden.
authors.forename: Nerrolyn
authors.initials: N
authors.lastname: Ramstrand
authors.affiliation: University Rehabilitation Institute, Ljubljana, Slovenia University of Ljubljana, Faculty of Medicine.
authors.forename: Helena
authors.initials: H
authors.lastname: Burger
authors.affiliation: University Rehabilitation Institute, Ljubljana, Slovenia University of Ljubljana, Faculty of Medicine.
authors.forename: Gaj
authors.initials: G
authors.lastname: Vidmar
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000534:rehabilitation*; D004867:Equipment Design; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices
keywords: Carpal tunnel syndrome; custom-made orthoses; grip strength; prefabricated orthoses